14 May 2019 Autor: Pedro de Araújo Gonçalves Coronary arteries irrigate the cardiac muscle (myocardium). In these arteries, atherosclerosis plaques may develop and interfere with the normal flow of blood. This problem is more important when risk factors are present, for example: Family history of atherosclerosis; Arterial hypertension; Tobacco consumption; Diabetes; High blood cholesterol. When there is no treatment or control of risk factors, atherosclerotic plaques in the coronary arteries tend to grow and can even lead to a sudden blood vessel occlusion, causing an acute myocardial infarction (heart attack). What are the symptoms of coronary heart disease? The most common symptom of an injury or obstruction of the coronary arteries is chest pain . However, sometimes, the perception is of tiredness or discomfort / weight / burning in the chest , which usually arises after an effort or stressful situation and relieves with rest or medication. In some patients, the manifestation of pain may be even more unusual, referring also to the back, abdominal, chin or arms pain . When the discomfort / weight / burning / pain in the chest arises on exertion and remains without relief at rest, or appears at rest, an acute myocardial infarction may be occurring . This is a clinical emergency: you must call 112 or the patient should be taken immediately to a hospital emergency service. How is the diagnosis of coronary disease made? In the presence of symptoms after an effort or stress, medical care should be sought to assess the problem, the presence of risk factors and, if indicated, to prescribe myocardial ischemia screening tests. The need to perform tests and the choice of the test to be performed is made by the physician according to the indications for each test and the patient and disease characteristics . These tests may include, for example, stress testing, overload echocardiography, coronary angio-CT, myocardial perfusion scintigraphy, cardiac magnetic resonance or coronary angiography. How is coronary heart disease treated? In the presence of a positive ischemia test and / or in the presence of typical symptoms of coronary heart disease, the doctor may decide to further investigate with a coronary angiography. Coronary angiography is an invasive exam that allows identifying the location and severity of the lesions and help to decide which treatment is the best. The treatments available are: Medication (pharmacological treatment); Coronary angioplasty and medication; Cardiac surgery and medication. Most patients with stable coronary disease or after an acute myocardial infarction, are able to live a normal life as long as : Duly treated; Risk factors are controled; Strict in taking medication. If there is no contraindication, it is important to maintain a healthy lifestyle, with healthy eating and regular physical exercise. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
